Revenue Cycle Specialist III

1 week ago


Boston, Massachusetts, United States East Boston Neighborhood Health Center Full time

About Us

East Boston Neighborhood Health Center is a leading community health center in the greater Boston area, dedicated to providing high-quality healthcare services to our patients and community.

Job Summary

We are seeking a highly skilled Revenue Cycle Specialist to join our team. As a key member of our Patient Accounts department, you will play a critical role in ensuring the smooth operation of our revenue cycle processes.

Key Responsibilities

  • Meet deadlines and productivity standards for Epic work queues, including but not limited to: Insurance verification (Epic RTE), Denials (research root cause, identify trends, correct, appeal), Claim Edits (ensure clean claim submission) & Transaction history (track claim submission and payor response)
  • Work the priority Epic work queues, projects and/or accounts and provide immediate feedback to management.
  • Utilize payor websites to research policies and coverage eligibility for use in claim adjudication, trend identification, and application for process improvement.
  • Utilize MS Office, with an emphasis on Excel to document, trend, and communicate workflow assignments, trends, and information vital to performance.
  • Apply transfers and/or adjustments to invoices as necessary to complete the resolution of each invoice.
  • Knowledge of ICD-10, Modifiers,Revenue Codes, HCPCS and CPT codes.
  • Coordinate data to complete special billing projects based on contractual obligations and regulatory demands.
  • Apply knowledge of insurance rules and regulations to interpret new insurance/HCFA/UB/HIPAA information and report potential impact.
  • Work along NeighborHealth Patient Accounts Leadership with various payors as part of the contact group responsible for updates and information required to assist others in the organization.
  • Participation in various projects and testing of updates for evaluation and implementation.

Requirements

  • High School Diploma or equivalent.
  • 3+ years of experience in a medical billing
  • 3+ years of Epic PB Resolute experience required
  • Demonstrate proficiency with a variety of automations, including but not limited to Epic, Microsoft Word, Excel, Email and electronic data processing skills
  • Working knowledge of insurance rules and regulations
  • Proficiency in PC software (i.e database)
  • Ability to manage multiple tasks/projects simultaneously

Preferred Qualifications

  • Proficiency level understanding of Medical Billing, ICD and CPT coding preferred.
  • Strong organizational skills and effective interpersonal skills
  • Excellent communication skills (verbal and written)

Benefits

  • Medical, dental, and vision coverage
  • Life and disability insurance
  • 401(k) retirement plan
  • Tuition reimbursement
  • Flexible spending and transportation accounts
  • Paid holidays, vacations, sick, and personal time
  • Generous staff development benefit
  • Excellent malpractice coverage
  • Pet insurance
  • Free parking
  • And much more


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